Surgery – Truss – Pad
Patent
1995-08-16
1998-06-23
Lateef, Marvin M.
Surgery
Truss
Pad
128920, 623901, 606 86, A61B 1700
Patent
active
057690782
DESCRIPTION:
BRIEF SUMMARY
BACKGROUND
The invention relates to a device and a process for preparing for and supporting surgical operations, in particular for preparing for and supporting bone grafting operations and transposition osteotomies.
When grafting a bone fragment on the cranium, representing one example of bone grafting, a graft is taken, preferably from the area of the iliac crest, after the pathologically altered or inoperably destroyed bone fragment has been removed. The graft is then machined to remove material at its edges in order to match its external form as far as possible to the cranial opening so that it can be fitted into the cranial opening without any substantial edge joints, which delay the healing process.
In the past machining of the graft has been carried out by hand and requires great manual dexterity on the part of the surgeon and a good spatial imagination in order to produce, in a few machining steps, a graft which fits well. However, for less experienced or practiced surgeons, this procedure is very time-consuming on the one hand, since it necessitates frequently comparing the graft to the cranial opening in order to prevent too much material being removed. On the other hand, these surgeons in most cases choose a relatively simple geometric shape as the contour for the cranial opening and for the graft in order to make the matching of the graft easier. But the result of this is that more healthy bone tissue is often removed from the cranium than is necessary, and that accordingly a larger graft has to be removed too, which consequently slows down the healing process at the donor site for the graft.
SUMMARY OF THE INVENTION
The invention is based on the object of developing a process and a device which make it possible to match a graft, regardless of its shape, with great accuracy to a grafting site.
In the present device, this object is achieved according to the invention with the aid of a numerically controlled positioning appliance which is arranged in a predetermined or measurable geometric relationship with respect to an operation site and to which at least one surgical instrument, a machining tool for the machining of tissue or bone, or a holder for the graft, can be releasably. The invention is based on the idea of using the high precision of numerical controls in order to machine the graft when matching it and/or in order to position it subsequently at the grafting site until it has been fixed.
In the presents process, the solution according to the invention proposes determining the individual anatomical morphology in the area of an intended operation site prior to surgery, and preparing the determined data as the basis for planning and/or simulating the operation, and also for numerical control of at least one positioning appliance which is arranged in a predetermined or measurable geometric relationship with respect to the operation site and to which a surgical instrument, a machining tool for tissue or bone, or a holder for a graft, can be releasably connected.
In preferred embodiment of the invention a holder can be connected to the positioning appliance, on which holder the graft is releasably secured. The positioning appliance can in this case be used without removal of the holder, both for the computer-aided movement of the graft, at the time of its machining, with great accuracy in relation to a stationary machining tool, for example a milling head, and also for the positioning of the finished graft at the grafting site until it is secured to the site. Alternatively, the holder with the releasably secured graft can be designed such that it can be secured both with the positioning appliance and also stationary in a predetermined or measurable geometric relationship with respect to a reference system. While in the stationary state, the graft is machined into the intended shape by a machining tool connected to the positioning appliance, and then the graft can be positioned by the positioning appliance after exchanging the machining tool for the holder.
In order to ensure high positioni
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Lateef Marvin M.
Shaw Shawna J.
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